Hashimoto’s and Fertility

Written By: Dr. Nathalie Burnier, ND

Hashimoto’s Disease and Fertility: How Hashimoto’s Disease can affect fertility and what you can do if you suspect you have it

What is it? 

Hashimoto’s disease is an autoimmune condition that affects your thyroid, which is the butterfly-shaped gland in your throat that produces hormones to regulate your metabolism and vital functions. It is the most common hypothyroid disorder, where there is an underproduction of thyroid hormones, and predominantly affects women. 

In Hashimoto’s, the immune system creates antibodies that attack your thyroid gland and its cells as if it is a bacteria, virus, or other foreign body. The exact cause is unknown, but it could be related to genetic factors and/or environmental triggers. 

How does it affect fertility?

An underproduction of thyroid hormones as well as the presence of autoimmune antibodies can negatively affect one’s ability to get and stay pregnant. 

When a thyroid disorder is unregulated, it can impact implantation, making it difficult to get pregnant or lead to implantation issues that can lead to an early miscarriage. Having abnormal TSH levels can also interfere with ovulation and when it’s not properly managed can lead to luteal phase issues and affect progesterone. Signs that your progesterone might be low could be changes to the length of your menstrual cycle or period, or lighter or heavier bleeding than is typical for you. 

Having low thyroid hormones can also lead to irregular menstrual cycles making it harder to conceive. It can impact ovulation and interfere with the release of the egg from the ovaries. Hypothyroidism also increases the risk of early miscarriage and premature birth. 

Even if TSH is in a normal range, having autoimmune antibodies can negatively impact fertility. It leads to an immune imbalance that can impact fertilization, implantation, as well as increase the risk of early miscarriage. 

Thyroid disorders can also affect men and their fertility. Abnormal thyroid function can damage sperm quality resulting in lower sperm count and motility. It can also impact libido, or sex drive, and contribute to erectile dysfunction.  


Symptoms of hypothyroidism and Hashimoto’s include:

  • Intolerance to cold (feeling colder than other people in the same room)
  • Irregular, frequent, and/or heavy menstrual bleeding
  • Dry skin and hair
  • Brittle nails
  • Hair loss
  • Fatigue and sluggishness
  • Increased sleepiness
  • Constipation
  • Muscle aches, tenderness, stiffness, and/or weakness
  • Joint pain and stiffness
  • Forgetfulness and difficulty concentrating 
  • Weight gain and/or difficulty losing weight
  • Depression
  • Low libido

These symptoms aren’t specific to Hashimoto’s and hypothyroidism however, so it’s important to get some lab testing done to pinpoint the exact cause of these symptoms. 

Lab Testing:

Specific lab testing to be done include:

  • TSH: Thyroid stimulating hormone (TSH) is produced by the pituitary gland in your brain. When the pituitary detects low levels of thyroid hormone in your blood, it sends out more TSH to tell the thyroid to make more thyroid hormone.
    • When it is high, this indicates low thyroid function, or hypothyroidism
    • We want this number to be below 2.5 when trying to conceive, and some people feel better with that number being lower than 2.5
  • T4: T4 (thyroxine) is the main thyroid hormone. A low level of T4 in your blood combined with high TSH levels confirms a low functioning thyroid gland. 
  • Antibodies: Antibody testing will determine whether Hashimoto’s is the cause of the hypothyroidism. Typically in Hashimoto’s, anti-TPO (anti-thyroperoxidase) will be elevated. Thyroperoxidase is an important protein that plays a role in thyroid hormone production and anti-TPO antibodies then attack these proteins in Hashimoto’s. 

What can be done:

  • Get your labs tested
  • Medication – synthetic T4 (levothyroxine) is likely (or should be) to be prescribed if your TSH levels are above 2.5. This will help to bring your TSH levels down into a safer level when trying to conceive and during pregnancy. It’s important to have your TSH levels retested after around 6 weeks of starting the medication to ensure the dosage is correct for you.  
  • Since your body is looking for indications that you are healthy enough to carry a child, physical activity and a healthy diet may help.
    • Aim for at least 150 minutes of physical activity each week 
    • Healthy diet that reduces inflammation (autoimmune diet or anti-inflammatory diet) – this is one of the first pillars we talk about in the Fertility Confidence Method program is how to reduce inflammation through nutrition
  • Stress reduction – managing your stress is particularly important when you have a thyroid issue as your adrenals (the gland that responds to stressors on your body by producing cortisol) help to support thyroid function; if your adrenals aren’t working properly that can also impact your thyroid
  • Different supplements can help as well:
    • Vitamin D – recommend getting it tested so you can supplement with the right dose
    • Selenium
      • Research to show that it can help reduce antibodies
      • Can get it through diet – macadamia and Brazil nuts are great sources
    • Zinc
      • Zinc is an essential element in producing thyroid hormone. It can be found in lentils and beans, shellfish, beef, and chicken. 

If you suspect you may have hypothyroidism or Hashimoto’s, I encourage you to go get tested and make sure your antibodies are tested as well.

If you feel you need support in figuring out what’s going on with your Hashimoto or more information about Thyroid function, feel free to book a FREE discovery call with me HERE and we start creating a strategic plan that will help you.

We encourage all our clients to get testing done so we can create a tailored approach to their hormones. We also go over how to read your test results and what to do about it.